Bones slowly get weaker as people age after hitting a peak bone density some time in a person's 30s. As bone strength decreases, the risk of broken bones rises. For some, the loss of bone density is enough to warrant a diagnosis of osteoporosis or osteopenia.
Definitions
Osteoporosis occurs when bone mineral density drops greatly, frequently resulting in fractures of the hip, spine and wrist. Osteopenia is considered a precursor to osteoporosis because it is a condition in which bones are less dense than normal but haven't lost enough density to be considered osteoporosis. Someone with osteopenia is at high risk for developing osteoporosis.
Causes
Osteopenia and osteoporosis do not have a definitive cause and may be partially determined by an individual's genetics. However, lifestyle choices are known to affect the development of these diseases and increase the risk of losing bone density. Specifically, deficiencies in calcium and vitamin D are linked to the development of osteoporosis and osteopenia. The use of steroid medications such as prednisone and cortisone also raise the risk of being diagnosed with low bone mass.
Tests
Assessing bone mineral density is the best way to determine the strength of bone and the risk of future fractures. Dual Emission X-ray Absorptiometry, otherwise known as DXA or DEXA, an X-ray scan of the hip or spine performed in a doctor's office, can calculate bone mineral density. The results are given as a T-score. A normal adult has a T-score of -1 or higher. Under -1 indicates osteopenia and -2.5 or lower results in a diagnosis of osteoporosis, according to the University of Michigan Health System article "Osteoporosis in Women." Ultrasound is also sometimes used to look at bone mineral density in the wrist or heel.
Treatments
There are two types of medications prescribed for osteoporosis and osteopenia. Most medications for these conditions are resorptives--drugs that slow the loss of bone and help prevent fractures. These, which include biphosphonates and calcitonin, can be used for existing osteoporosis or in people with osteopenia who want to prevent osteoporosis from developing. One newer medication, the parathyroid hormone Teriparatide, works instead to build bone mass and increase bone density, according to the Mayo Clinic. Another treatment for osteoporosis in postmenopausal women is hormone or estrogen therapy, but these treatments have severe potential side effects so they aren't used as often as resorptives or Teriparatide. Alternative therapies for the treatment of osteoporosis include red clover, soy and physical therapy, although soy and red clover are still under investigation regarding their effectiveness, according to the National Center for Complementary and Alternative Medicine.
Prevention
Prevention of osteopenia and osteoporosis begins early in life, since the best defense against these conditions is to build up bone density while young. Adequate intake of calcium and vitamin D and engaging in weight bearing exercise on a regular basis during childhood and adolescence can build up a natural protection against low bone density later in life. For those past their peak bone building years, these things are still helpful in maintaining bone later in life, according to the University of Michigan Health System.
Complications
If left untreated, significant complications can arise from osteoporosis or osteopenia. The weak and brittle bones that characterize these conditions are prone to breakage and fractures are common in the hip and spine. Vertebral compression fractures, a crumbling or disintegration of spinal vertebrae, can lead to other problems including stooped posture, loss of height and severe back pain.
